"In order to continue to protect privacy in a manner that promotes trust between individuals and health care providers and advances access to, and improves the quality of, health care, [HHS has] determined that the Privacy Rule must be modified to limit the circumstances in which provisions of the Privacy Rule permit the use or disclosure of an individual's PHI about reproductive health care for certain non-health care purposes, where such use or disclosure could be detrimental to privacy of the individual or another person or the individual's trust in their health care providers."   MORE >>

"Starting In 2025, Part D begins to function more like traditional non-Medicare coverage, with a true OOPM of $2,000. This and other benefit improvements under Part D means that employers who cannot use the simplified method will be held to a heightened threshold for determining creditability. Some employer sponsored plans that are creditable in 2024 under an actuarial determination will likely not be creditable in 2025. Employers who wish to keep creditable coverage in 2025 may need to make certain plan design changes to improve the actuarial value of the plan's prescription drug benefits."   MORE >>

"For employers, the key change is that group fixed indemnity policies are subject to a new notice requirement. The notice, which must be in 14-point font, is intended to make clear that the policy is not health insurance. It reads as follows:"   MORE >>

"While technical standards for insured GFE and AEOB implementation are still being developed, a potential real-world pilot or demonstration project of these standards may provide meaningful feedback for future iterations of data exchange standards and more complex use cases, as well as help guide future policy decisions"   MORE >>

"The case for differentiating employee contributions by lifestyle behaviors is particularly strong, considering that the evidence now shows, at a granular level, that small changes to a few key behaviors such as physical activity, have a causal impact on risk, and this is true across the risk spectrum. Furthermore, advances in data and technology (wearables), now allow for individualized pathways and measurement."   MORE >>

"Patient education and counseling ... constitute a major component of a successful price transparency initiative.... After patients use the estimator tool, a survey is deployed to assess their experience. Data suggest shoppable services such as imaging and surgeries are the procedures that most frequently draw interest."   MORE >>

"[CMS] has committed to having all Medicare beneficiaries in value-based payments (VBPs) by the end of this decade.... Yet, today only about one third of traditional Medicare beneficiaries are in an accountable care organization (ACO). The uptake of VBP has been slow, slower than many people have expected.... One answer is to more carefully design the VBP programs. In this article, [the authors] delineate three major design flaws in current programs that impede expansion of VBPs, and how they can be fixed."   MORE >>

"Even if you are the fiduciary of a plan that might not be the perceived subject of a mega class-action lawsuit, these back-to-the-basics best practices apply to plans of all sizes. For plan sponsors, consider the following: [1] Establish an investment committee ... [2] Consider regular fiduciary updates/training for plan committee members.  ... [3] Be thoughtful about the information that the committee makes publicly available ... [4] If forfeitures are used to offset employer contributions, make sure that specific language is in the plan document ... [5] If the plan has target date funds, revisit the DOL's tips from 2013 and ensure selection and monitoring is in-line with the same."   MORE >>